光学相干断层扫描血管成像术在湿性年龄相关性黄斑变性诊断中的临床应用价值

Clinical Value of Optical Coherence Tomography Angiography in the Diagnosis of Wet Age-related Macular Degeneration

目的:探讨光学相干断层扫描血管成像术(OCTA)在湿性年龄相关性黄斑变性(AMD)诊断中的临床应用价值。方法:选取2021年9月—2022年9月中山市人民医院收治的初次诊断为湿性AMD的患者70例为研究对象。所有研究对象接受初始3个月每月玻璃体腔注射给药1次,后按需给药(PRN),即3+PRN方案治疗,给药3次后复查,进行荧光素眼底血管造影(FFA)、OCTA检查。分析FFA、OCTA结果图像,比较两项检查在视网膜新生血管、黄斑水肿2项眼底病变指标的检出率和检出一致性。结果:两种方法视网膜新生血管、黄斑水肿检出率比较,差异无统计学意义(P>0.05)。FFA与OCTA检出视网膜新生血管、黄斑水肿的一致性良好(Kappa=0.896、0.909,P<0.001)。结论:应用OCTA检查与FFA检查湿性AMD患者视网膜新生血管、黄斑水肿的一致性较高,可用于替代FFA检查。

Objective:To investigate the clinical value of optical coherence tomography angiography(OCTA)in the diagnosis of wet age-related macular degeneration(AMD).Methods:A total of seventy patients with wet AMD who were first diagnosed in Zhongshan People's Hospital from September 2021 to September 2022 were selected as the study objects.All subjects received intravitreal injection once a month for an initial 3 months,followed by on-demand administration(PRN),a 3+PRN regimen.Fluorescein fundus angiography(FFA)and OCTA were performed after 3 times of administration.The results of FFA and OCTA were analyzed,and the detection rate and consistency of the two tests in retinal neovascularization and macular edema were compared.Results:There was no significant difference in the detection rates of retinal neovascularization and macular edema between the two methods(P>0.05).FFA and OCTA showed good consistency in detecting retinal neovasculum and macular edema(Kappa=0.896,0.909,P<0.001).Conclusion:OCTA test has high consistency with FFA test for retinal neovascularity and macular edema in patients with wet AMD,and can be used as an alternative to FFA test.